Friday, August 06, 2010


Obesity, of course is the growing trends in developed and developing nations. In the US, there has been a noticeable decline in the number of deaths from CAD, but this is quickly offset by an increasing incidence of obesity. It would then be a matter of time before the decline in CVS mortality, be reversed. In Malaysia, we have also seen an increasing rate of obesity. Depending how you define obesity, the incidence of obesity could vary from 30-50%. It is a growing concern. Our calls to the government to take active measures, on a nationwide population basis, has met with limited success. The removal of sugar subsidy, is a step in the right direction ( although I doubt that health was the main reason ). It would have been good if the government can also limit the number of fast food joints, limit the amount of sugar in soft drinks and teh tarik, and also limit the amount of roti canai joints. All these foods are very very unhealthy.
Anyway, what I wanted to discuss today was a study by Dr Gary Foster, published in the Aug 3rd Annals of Internal Medicine, on weight loss and metabolic outcomes after 2 years, comparing the low carb diet ( modified Arkin's ) and a low fat diet. It is important to note that this is one of the few studies with a 2 year followup, and also in this study, in addition to the diet, subjects were also given comprehensive behavioural coaching, meaning that they had counselling sessions, food diary, weight diary, exercise programs, etc, all coached to them
Well with 307 subjects, half on the modified Arkin's ( low carbs diet ) and half on a low fat diet, after 2 years, the degree of weight loss was essentially the same ( about 7% after 2 years ). Neither diet was better then the other. However, the authors noted that with the low carb diet, there was a significantly higher rise in HDL-C at all points of the program. Some subjects on low carbs diet, had significant weight loss with an almost 50% increase in HDL-C after 2 years. I must say that this is not what I see in my medical practice. It is so very difficult to raise your HDL-C without the use of drugs. But Dr Foster and colleagues seem to be able to do it. Whether or not this will translate to a lower incidence of heart disease, I do not know, but it is certainly a step in the right direction.
No drugs, just discipline and some counselling, may be the best thing to help lose weight and also improve your cardio-protection.

1 comment:

家唐銘 said...